Fukuda Masataka, Kawagoe Izumi, Kochiyama Tsukasa, Ando Nozomi, Kudoh Osamu, Satoh Daizoh, Hayashida Masakazu
Department of Anesthesiology and Pain Medicine, Juntendo University Faculty of Medicine, 2-1-1 Hongo, Bunkyo-ku, 113-8421, Tokyo, Japan.
JA Clin Rep. 2021 Jan 28;7(1):13. doi: 10.1186/s40981-021-00414-2.
The indications for robot-assisted urologic surgeries have expanded due to their low invasiveness. However, complicated surgical procedures lead to prolonged surgical duration, requiring patients to remain in the lithotomy position for an extended time. Well leg compartment syndrome (WLCS) is a known severe postoperative complication related to the lithotomy position.
We report a case of WLCS after robot-assisted radical cystectomy (RARC), in which the patient recovered without neurological sequelae. A 55-year-old, obese male who underwent RARC complained of right leg pain and paresthesia 3 h after the surgery that lasted for 481 min. Emergency evaluation revealed unilateral WLCS in the anterior and lateral compartments. Urgent fasciotomy was performed 4 h after symptom onset. He thereafter recovered completely and was discharged without any neuromuscular dysfunction.
Early detection of WLCS, surgical treatment, and additional measures are crucial to prevent its life-threatening and/or disabling outcomes.
由于机器人辅助泌尿外科手术具有微创性，其适应证已有所扩大。然而，复杂的手术操作会导致手术时间延长，这就要求患者长时间保持截石位。腿部间室综合征（WLCS）是一种已知的与截石位相关的严重术后并发症。
我们报告一例机器人辅助根治性膀胱切除术（RARC）后发生WLCS的病例，该患者康复后未出现神经后遗症。一名55岁的肥胖男性接受了RARC手术，手术持续了481分钟，术后3小时他抱怨右腿疼痛和感觉异常。紧急评估显示前侧和外侧间室出现单侧WLCS。症状出现4小时后进行了紧急筋膜切开术。此后，他完全康复并出院，没有任何神经肌肉功能障碍。
早期发现WLCS、手术治疗及其他措施对于预防其危及生命和/或致残的后果至关重要。
